drbcshah
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Epidural hematomas most commonly occur due to temporal-parietal skull fractures that lead to rupture of the middle meningeal artery. It more commonly occurs after road traffic accidents and is also common in young adults, sex wise males with a greater preponderance than females.
Clinically lateral transtentorial herniation occurs and there is a lucid interval between consciousness and coma. There are no focal signs.
Investigation of choice is CT scan without contrast that reveals a high density biconvex mass against the skull. It is usually lenticular-shaped with uniform densities and sharp margins, usually limited by the suture lines as shown in the presentation above.
Treatment is craniotomy with head elevation and pre-operation mannitol.
The prognosis is good. The presentation above fits epidural hematoma and an added point is the physical exam is normal which occurs with these hematomas.
Subdural hematomas occur with rupture of vessels that bridge the surface of cerebral hemisphere and the skull or a cerebral laceration. Risk factors include use of anticoagulants, elderly, alcohol abuse and patients with csf shunts. There are no lucid periods and focal signs usually appear later. The CT scan shows a high density concave mass which is usually less uniform and dense and more diffuse than an epidural hematoma. The prognosis is poor because the brain is injured.
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| Ig F
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VERY GOOD........
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i m not perfect but i wanna get close to it......
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